Page 18 - Lake Avenue Church Benefits Guide 2020

Employee Contributions

This chart compares the monthly contributions for our Employee Benefit plans. Your cost for coverage will vary depending on the option
and level of coverage you choose. Employee contributions for Medical, Dental, and Vision are deducted from your paycheck with pre-tax
dollars. This means that contributions are taken from your earnings before taxes, resulting in lower taxes and increased take home pay.

Cost per Month Cost per Paycheck
(24 paychecks)

Aetna Value Ded HMO Select Network
Employee Only $41.66 $20.83
Employee + Spouse $91.66 $45.83
Employee + Child(ren) $74.99 $37.49
Employee + Family $129.15 $64.57
Aetna Value HMO Select Network
Employee Only $80.51 $40.25
Employee + Spouse $177.14 $88.57
Employee + Child(ren) $144.92 $72.46
Employee + Family $249.60 $124.80
Aetna Classic PPO
Employee Only $247.14 $123.57
Employee + Spouse $543.73 $271.86
Employee + Child(ren) $444.86 $222.43
Employee + Family $766.15 $383.07
Lincoln Dental PPO
Employee Only $10.00 $5.00
Employee + Spouse $20.00 $10.00
Employee + Child(ren) $30.00 $15.00
Employee + Family $40.00 $20.00
Lincoln Vision
Employee Only $0.20 $0.10
Employee + Spouse $0.40 $0.20
Employee + Child(ren) $0.50 $0.25
Employee + Family $0.60 $0.30

MetLife Accident
Employee Only $19.11 $9.55
Employee + Spouse $29.47 $14.73
Employee + Child(ren) $33.41 $16.72
Employee + Family $41.38 $20.70
MetLife Hospital Low
Employee Only $26.00 $13.00
Employee + Spouse $51.05 $25.52
Employee + Child(ren) $40.60 $20.30
Employee + Family $63.79 $31.89

MetLife Hospital High
Employee Only $42.73 $21.36
Employee + Spouse $83.76 $41.88
Employee + Child(ren) $66.78 $33.39
Employee + Family $104.74 $52.37
 Basic Life and AD&D Insurance, Short Term Disability, Long Term Disability, EAP: Provided to you at no charge and are paid
by Lake Avenue Church.
 Voluntary Life and AD&D Insurance Benefit, Voluntary Legal Plans, Voluntary Supplemental Plans: Available to you at
discounted group rates. Should you elect these benefits, you will pay 100% of the cost.
 For Critical Illness, your premium is based on your Issue Age, meaning your initial rate is based on your age at the time your
coverage becomes effective and your rates will not increase due to age.
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